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MLA CE305 - Disaster Health Information Sources: The Basics


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Slides for Continuing Education CE305 offered May 19, 2012 at the Medical Library Association annual conference in Seattle, WA.

Slides for Continuing Education CE305 offered May 19, 2012 at the Medical Library Association annual conference in Seattle, WA.

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  • 1. Disaster Health Information Sources:13:00 – 17:00May 19, 2012 The BasicsCE305 MLA 2012 Robin Featherstone, MLIS Liaison Librarian (Medicine) Life Sciences Library, McGill University
  • 2. Publications on Disaster Topics Graph created using GoPubMed:
  • 3. H1N1 Cases: March 15 to April26, 2009
  • 4. H1N1 Web Activity: March – June,2009 Timeline created using dipity:
  • 5. Objectives By the end of the course, you will: 1.Be comfortable locating disaster health information 2.Be confident using a variety of disaster health databases, tools and websites 3.Be knowledgeable about initiatives and technologies for accessing disaster health information
  • 6. Agenda •Intro - Disaster Medicine & Disaster Workforce •Case Discussion •Disaster Literature •Search Exercises •BREAK •NLM Resources for Disaster Health Information •Search Exercises •BREAK •Tools – Apps, Email Lists, RSS, Widgets •Summary •Practice Exercises
  • 7. What is a Health Disaster? A precipitous or gradual decline in overall health status of a community for which the community is unable to cope without outside assistance. WADEM, 2003
  • 8. Related Terms Disaster: a serious disruption of the functioning of society, causing widespread human, material or environmental losses which exceed the ability of affected society to cope using only its own resources. Emergency: a situation that is out of control and requires immediate attention. Event: an occurrence that has the potential to affect living beings and/or their environment; a realization of a hazard. IDNDR, 1992 WADEM, 2003
  • 9. Disaster Medicine: An OverviewResearch & Epidemiology Public Health & Emergency Specific Disasters Management Systems-Education & training -Legislation & regulations -Traumatic & explosive events-Surge capacity -Surveillance -Chemical events-Ethics -Triage -Biological events-International perspectives -Protective equipment -Nuclear & radiological events-Emerging infectious diseases -Decontamination -Hazmat, toxic & industrial-Mental & behavioral health -Distribution of medications events -EMS scene management -Floods -Hospital facility disaster -Hurricanes management -Tornados -Mortuary services -Earth quakes -Telemedicine & telehealth -Tsunami -Patient identification & -Winter storms tracking -Heat waves -Volcanoes Koenig & Schultz, 2010
  • 10. Disaster Workforce Licensed or trained Paid or volunteer Permanent or as-needed workers … who play a defined role in… All-hazards preparedness, response and recovery In implementing Emergency Support Functions 6 & 8: Mass care, Emergency Assistance, Disaster Housing & Human Services; Public Health and Medical Services
  • 11. Disaster Workforce: Licensed/credentialedhealth professionals (ESAR – VHP, 2011)
  • 12. Disaster Workforce: Additionallicensed or trained professionals
  • 13. Case Discussion: Pandemic At the end of April, 2009, an administrator from a hospital critical incident planning team asks you to find information to answer the question: What is the effectiveness of antiviral agents for H1N1? What are some specific challenges related to finding information in this case? How would you approach this question?
  • 14. Disaster Health InformationPeer-reviewed scholarly literature• Journal articles• Books HazLit Database“Grey” Literature• Reports• Summaries• Surveillance data• Training materials• Conference proceedings
  • 15. Disaster Literature - Journals • American Journal of Disaster Medicine • Disasters • Disaster Management and Response • Prehospital and Disaster Medicine • Biosecurity and Bioterrorism • Journal of Business Continuity and Emergency Planning
  • 16. Describing Disaster Medicine • LC subjects – Disaster Medicine • Disaster hospitals • Disaster nursing • MeSH - • DIMRC’s Disaster Glossaries: • USFA Library Fire, EMS and Emergency Management Thesaurus - • No Doody’s category for “disaster medicine” – try instead: – Emergency Medical Services – Emergency Medicine – Public Health • WorldCat categories – Emergency Medical Services – Emergency Management – Emergencies – Disaster Planning – Disaster Medicine (>1000 books)
  • 17. NLM’s Emergency Access Initiative • Provides free access to full- text articles from biomedical journals and reference books for areas affected by disasters • Activated for Haiti earthquake, Gulf oil spill, floods in Pakistan, and the 2011 Tōhoku earthquake and tsunami • Partnership with publishers • 200+ journal titles • 30+ reference books
  • 18. Exercise: Information forProfessionals A child psychiatrist asks you to find articles to answer the question: What is the post-hurricane pattern of behavioral and emotional problems in children? 1.HazLit: 2.PubMed: 3.NCBI Bookshelf:
  • 19. Exercise: Information forProfessionals Find documents outlining procedures for preparing hospitals for an earthquake 1.DIMRC (Disaster Information Management Research Center) - Resource Guide for Disaster Medicine and Public Health: 2. Cochrane Evidence Aid: reviews/evidence-aid-project 3.PAHO (Pan American Health Organization) – Area on Emergency Preparedness and Disaster Relief: 4.PubMed:
  • 20. Professional Information - Federal ASPR’s (Office of the Assistant Secretary for Preparedness and Response) Public Health Emergency CDC’s Emergency Preparedness and Response – Pages for Professionals FEMA’s NIMS (National Incident Management System) Resource Center FEMA’s NRF (National Response Framework) Resource Center
  • 21. Professional Information - Associations American Academy of Pediatrics American College of Emergency Physicians American Red Cross World Association for Disaster and Emergency Medicine
  • 22. Professional Information – AcademicCenter for Biosecurity at the University of Pittsburgh Medical Center for Infectious Disease Research & Policy (CIDRAP) for the Study of Traumatic Stress Research Center at the University of Delaware of Medicine Forum on Medical and Public HealthPreparedness for Catastrophic Events
  • 23. Exercise: Disaster HealthInformation for the Public Use the following resources to find information on health hazards after a flood for a consumer audience. 1. CDC 2. DIMRC 3. FEMA 4. MedlinePlus 5.
  • 24. Surveillance Exercise Find recent incidence figures for Influenza 1.CDC – MMWR State Health Statistics: 2.ECDC – Surveillance: 3.WHO – Global Alert and Response:
  • 25. Exercise A hospital’s critical incident planning team is developing an all hazards preparedness training program on medical surge. Find best quality evidence to assist their planning.
  • 26. Break
  • 27. NLM’s Disaster Information Tools& Mobile Applications: WISER •For HazMat (hazardous materials) / CBRN (chemical, biological, radiological, and nuclear) events •Designed for: First responders (fire fighters), HazMat teams, EMS/Paramedics, Emergency Department personnel •Stand-alone and enhanced (wireless) capabilities •Training materials available:
  • 28. NLM’s Disaster Information Tools& Mobile Applications: WISER• HazMat/CBRN InformationIncludes:• Substance properties• Chemical identification tool• Procedures for emergency responders• Medical treatment data• Safe protective distance mapping - GIS
  • 29. WISER Platforms Stand-alone (download) applications WebWISER – Internet connection needed
  • 30. WISER Exercise*1. Search WISER to answer the question: What type of personal protective equipment (PPE) & protective distance is required for a large spill of xylenes?
  • 31. NLM’s Disaster Information Tools& Mobile Applications: REMM •Radiation Emergency Medical Management •For health care workers diagnosing and treating patients during radiological/nuclear events •Provides evidence-based information for those without formal radiation medicine expertise •Stand-alone application available on many platforms and mobile devices
  • 32. REMM Platforms •Web – •Downloadable versions for Windows and Mac •Mobile REMM, with selected key files from the full version •Selected content included in WISER
  • 33. REMM Exercise: 1. Search REMM to find out how to perform a survey for radiation contamination 2. Search REMM to answer the question: What is the treatment for a patient who presents with no injuries and was exposed to radiation at 9:00 today and began vomiting at 15:00?
  • 34. NLM’s Disaster Information Tools& Mobile Applications: CHEMM •Chemical Hazards Emergency Medical Management •For first responders, first receivers, other healthcare providers, and planners •Contains information to plan for, respond to, recover from, and mitigate the effects of incidents involving chemicals •Content can be downloaded to your computer •Includes identification tools and medical management guidelines for chemical groups and syndromes
  • 35. CHEMM Exercise: 1. Search CHEMM to answer the question: Identify the syndrome for an unconscious patient who has been exposed to an unknown chemical and presents with pinpoint pupils, arrhythmia and is sweaty? 2. What is the recommended treatment for this patient in the emergency department?
  • 36. Exercises Use NLM’s resources to answer the following questions: 1.What are guidelines for setting up a chemical decontamination area outside a hospital emergency department? 2.What disaster triage category should be assigned to a patient who cannot walk, exhibits spontaneous breathing and a respiratory rate greater than 30?
  • 37. Break
  • 38. Role of Social Media “Clearly, social media are changing the way people communicate not only in their day-to-day lives, but also during disasters that threaten public health.” (Merchant, 2011)
  • 39. Stay Informed • Apps • Email Lists • RSS (Really Simple Syndication) • Twitter • Widgets
  • 40. Stay Informed - Apps • Disaster Apps and Mobile Optimized Web Pages: l • Relief Central • Free mobile and web resource • To assist relief workers, first responders, and others called to serve in disaster relief situations around the world
  • 41. Stay Informed – Email Lists • CDCs Healthcare Preparedness Info list: USCDC_512 • DIMRC’s DISASTR-OUTREACH-LIB: • ISID’s ProMED-Mail:
  • 42. Stay Informed - RSS
  • 43. Stay Informed - RSS • CDC: – Contains dozens of RSS feeds on disaster topics – Includes the MMWR • ECDC: – Includes epidemiological updates, influenza surveillance data and other public health news • FEMA: – Contains disaster declarations by state, mitigation best practices, information on disaster recovery centers, and more • NLM: – Includes updates from NLM’s division of Specialized Information Services, which includes DIMRC • WHO: – Contains Disease Outbreak, and Emergencies and Disasters news feeds
  • 44. Stay Informed – Twitter • Twitter subscribers receive real-time updates • 140 character maximum • Look for the blue bird or the blue “t” on websites to find an institution’s twitter account • Used by many disaster health information providers…
  • 45. Stay Informed – Twitter US Government International • USAID - @USAID • American Red Cross - @RedCross • FEMA - @fema • IFRC - @Federation • WHO News - @whonews • CDC Emergency - @CDCemergency • PAHO Disasters Area - @PAHOdisasters • PAHO/WHO Equity - @eqpaho • NACCHO - @NACCHOalerts • WHO/PAHO EOC - @pahoeoc • NLM DIMRC - @NLM_DIMRC • ReliefWeb - @reliefweb • US EPA Web - @EPAweb • FluGov - @FluGov Others • ASPR - @PHEgov • Doctors w/o Borders - @MSF_USA • StateDept - @StateDept • CrisisCommons - @CrisisCommons • Crisis Social Media - @CrisisSocMed • Natural Hazards Center - @HazCenter • Crisis Mappers - @CrisisMappers
  • 46. Stay Informed – Twitter Common emergency management hash tags #HSEM Homeland Security Emergency Management #Outbreak Disease Outbreak #CBRNE Chemical, Biological, Radiological, Nuclear and Explosive #Hazmat Hazardous Materials #SMEM Social Media Emergency Management #Twoat Tropical Weather Outlook Atlantic … and many more. See:
  • 47. Stay Informed - Widgets
  • 48. Stay Informed - Widgets • CDC Widgets - • DIRLINE for state disaster organizations - dimrc.html#dirline • FEMA Widgets -
  • 49. Summary1. NLM’s ________ gives free access to literature to areas affected by disasters.2. Some topics under the subject “Disaster Medicine” include _________, _________, __________.3. Use ________ to find peer-reviewed journal articles and books on disaster health topics.4. _________ includes diagnostic information for chemical exposure?5. First responders use ________ to identify unknown toxic agents.6. _________ are examples of a surveillance tools.
  • 50. Key Points 1. An influx of information and research interest will commonly occur shortly after a major disaster. Be prepared to answer questions and consider using tools like RSS and email lists to monitor information as it is being produced.
  • 51. Key Points 2. The “disaster workforce” is very large and contains both licensed professionals and volunteers. Consider using sources for both a professional and public/consumer audience when proving disaster health information.
  • 52. Key Points 3. There are more “Grey Literature” sources of disaster health information than peer-reviewed, indexed sources. Use a combination of bibliographic databases, federal websites and aggregators, surveillance tools, professional associations, and academic centers to locate disaster health literature.
  • 53. Key Points 4. NLM’s tools contain specialized information for first responders and receivers. Consider the nature of the disaster/emergency when recommending a tool. • WISER for Haz/Mat, CBRNE • REMM for radiological • CHEMM for chemical
  • 54. Key Points 5. Social software is revolutionizing the method of delivering disaster health information. Use apps, email lists, RSS, Twitter & widgets to stay informed.
  • 55. Practice Exercises • Answer the question: What are recommendations regarding hospital oxygen supplies for an influenza pandemic? • Find recent incidence figures for cholera • Find consumer information on the health effects of wild fires • Answer the question: How do you diagnose for wound contamination from radioactive shrapnel? • Find best evidence on facemask use by children during respiratory infectious disease outbreaks
  • 56. References & Further Reading Barbisch, D., Haik, J., Tessone, A., & Hanfling, D. (2010). Surge Capacity. In Koenig and Schultz’s Disaster Medicine: Comprehensive Principles and Practice. New York: Cambridge University Press. 33-49. CDC. (2011). Preparedness for All Hazards. Accessed August 13, 2011 from: DMORT (Disaster Mortuary Operational Response Teams). (2011). Who Makes Up a DMORT Team? Accessed August 13, 2011 from: ESAR-VHP (The Emergency System for Advance Registration of Volunteer Health Professionals). (2011). Who is Eligble? Accessed August 13, 2011 from: FEMA. (2008). Emergency Support Function Annexes: Introduction. Accessed August 6, 2011 from: IDNDR (International Decade of Natural Disaster Reduction). 1992. Internationally agreed glossary of basic terms. Kaji, A., Koenig, K., Bey, T. (2006). Surge capacity for healthcare systems: a conceptual framework. Acad Emerg Med. 13(11). 1157- 1159. Koenig, K.L., & Schultz, C.H, (Eds.). (2010). Koenig and Schultz’s Disaster Medicine: Comprehensive Principles and Practice. New York: Cambridge University Press. Merchant, R.M., Elmer, S. & Lurie, N. (2011). Integrating Social Media into Emergency-Preparedness Efforts. NEJM. 365(4). 289- 291. Turoff, M., & Hiltz, S. R. (March 6, 2008). Information Seeking Behavior and Viewpoints of Emergency Preparedness and Management Professionals Concerned with Health and Medicine. Report prepared for the National Library of Medicine. Accessed April 8, 2012 from: WADEM (World Association for Disaster and Emergency Medicine). (2003). Glossary of Terminology. In Health Disaster Management: Guidelines for Evaluation and Research. Vol. 1. Madison: Prehospital and Disaster Medicine. Accessed September 8, 2011 from Yong, E. (2011). Disease Trackers. BMJ. 343(7814). 70-71.
  • 57. Photo Credits* Widgets Embedded on Public Website by and the National Center for Media Engagement: F5 tornado Elie Manitoba 2007 by Justin1569 at en.wikipedia: 2007.jpg GDE Bridge Collapse by Richard, Enzyme05’s photostream: Radiologist in San Diege CA 2010 by Zackstarr: A_2010.jpg Tamiflu NOR by KEN: * Public domain image files downloaded from Wikimedia Commons. Attribution given as indicated by creators where applicable.
  • 58. Questions